skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Ichthyosiform scaling secondary to megavoltage radiotherapy

Abstract

Acquired ichthyosis is a rare dermatosis associated with a number of malignancies. Side effects seen on the skin secondary to megavoltage radiotherapy are uncommon but may include fine dry desquamation and tanning. The authors present a case of ichthyosiform scaling limited to the radiation fields in a patient treated for brain metastases of a primary small cell lung carcinoma. The reader is reminded that side effects of megavoltage treatment do occur on the skin. A brief review of these effects is included. 5 references.

Authors:
 [1]
  1. (National Naval Medical Center, Bethesda, MD (USA))
Publication Date:
OSTI Identifier:
5262693
Resource Type:
Journal Article
Resource Relation:
Journal Name: Curtis; (United States); Journal Volume: 48:1
Country of Publication:
United States
Language:
English
Subject:
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.; DERMATITIS; RADIOINDUCTION; RADIOTHERAPY; SIDE EFFECTS; BRAIN; CARCINOMAS; LUNGS; METASTASES; PATIENTS; RADIATION INJURIES; BIOLOGICAL EFFECTS; BIOLOGICAL RADIATION EFFECTS; BODY; CENTRAL NERVOUS SYSTEM; DISEASES; INJURIES; MEDICINE; NEOPLASMS; NERVOUS SYSTEM; NUCLEAR MEDICINE; ORGANS; RADIATION EFFECTS; RADIOLOGY; RESPIRATORY SYSTEM; SKIN DISEASES; THERAPY 560151* -- Radiation Effects on Animals-- Man

Citation Formats

Ross, E.V. Ichthyosiform scaling secondary to megavoltage radiotherapy. United States: N. p., 1991. Web.
Ross, E.V. Ichthyosiform scaling secondary to megavoltage radiotherapy. United States.
Ross, E.V. 1991. "Ichthyosiform scaling secondary to megavoltage radiotherapy". United States. doi:.
@article{osti_5262693,
title = {Ichthyosiform scaling secondary to megavoltage radiotherapy},
author = {Ross, E.V.},
abstractNote = {Acquired ichthyosis is a rare dermatosis associated with a number of malignancies. Side effects seen on the skin secondary to megavoltage radiotherapy are uncommon but may include fine dry desquamation and tanning. The authors present a case of ichthyosiform scaling limited to the radiation fields in a patient treated for brain metastases of a primary small cell lung carcinoma. The reader is reminded that side effects of megavoltage treatment do occur on the skin. A brief review of these effects is included. 5 references.},
doi = {},
journal = {Curtis; (United States)},
number = ,
volume = 48:1,
place = {United States},
year = 1991,
month = 7
}
  • Purpose: To utilize image-guided radiotherapy (IGRT) in near real time by obtaining and evaluating the online positions of implanted fiducials from continuous electronic portal imaging device (EPID) imaging of prostate intensity-modulated radiotherapy (IMRT) delivery. Methods and Materials: Upon initial setup using two orthogonal images, the three-dimensional (3D) positions of all implanted fiducial markers are obtained, and their expected two-dimensional (2D) locations in the beam's-eye-view (BEV) projection are calculated for each treatment field. During IMRT beam delivery, EPID images of the megavoltage treatment beam are acquired in cine mode and subsequently analyzed to locate 2D locations of fiducials in the BEV.more » Simultaneously, 3D positions are estimated according to the current EPID image, information from the setup portal images, and images acquired at other gantry angles (the completed treatment fields). The measured 2D and 3D positions of each fiducial are compared with their expected 2D and 3D setup positions, respectively. Any displacements larger than a predefined tolerance may cause the treatment system to suspend the beam delivery and direct the therapists to reposition the patient. Results: Phantom studies indicate that the accuracy of 2D BEV and 3D tracking are better than 1 mm and 1.4 mm, respectively. A total of 7330 images from prostate treatments were acquired and analyzed, showing a maximum 2D displacement of 6.7 mm and a maximum 3D displacement of 6.9 mm over 34 fractions. Conclusions: This EPID-based, real-time IGRT method can be implemented on any external beam machine with portal imaging capabilities without purchasing any additional equipment, and there is no extra dose delivered to the patient.« less
  • Attempts were made to develop a radiotherapy technique to increase the sensitivity of various types of tumors by exposing the patient to oxygen at high pressure in a specially constructed chamber while undergoing high-voltage x-ray treatment. Results are reported for 110 cases of locally advanced malignant tumors in various sites that have received treatment combining oxygen barotherapy with 4-Mev x-ray therapy, delivering three large fractions of x-ray dosage in a total time of 21 days. Each patient received general anesthesia, bilateral myringotomy, and pressurization of oxygen to 45 lb/in./sup 2/ gauge pressure in a pressure vessel. Cases treated during themore » first 10 months are reported in relation to their status from 2 months after treatment. Immediate tumor resolution was good but severe radiation reactions required reduction of the dosagn first used. Reduction of the dose to 3 x 1000-rad maximum tumor dose did not significantly alter the sequelae and more recently a maximum tumor dose of 3 x 800 rad was used. The reduced dosage was well tolerated, being no worse than that expected when conventional techniques were used to deliver 6000 to 6500-rad tumor doses in 5 to 6 weeks with 4-Mev x rays. The higher doses in oxygen showed mucosal reactions similar to those seen nt the site of a radon implant producing 6000 to 7000-rad tumor doses in 5 to 7 days but of course involved much larger volumes of tissue. Experience with similar large doses delivered in air, compared with those used with barotherapy, suggests that dose for dose the mucosal reactions were more intense with barotherapy. Animal lab studies lended suppont to this conclusion. Skin reactions, on the other hand, seemed to parallel the dosage received on the skin and not to be aggravated by oxygenation effects. Tumor resolution with the various dosage schemes employed was very satisfactory and often dramatic. Delayed necroses appeared commonly five months after completing treatment in those cases treated with high doses who developed the most intense mucous membrane reactions even though healing was almost complete 2 to 3 months after treatment. The use of antibiotics, conticosteroids, and triiodothyronine did not infiuence progression. Definite local recurrence of tumor within the treated volume was confirmed in only a few cases. In three patients, comparison was possible of the tumor resolution produced by the barotherapy technique with the resolution produced when similar dosage was given in air to a regional metastasis later appearing. The resolution was far superior with barotherapy. Bilateral myringotomy produced temporary deafness, usually unilaterai, in approximately 20% of the cases, and oniy four patients have any residual deafness. It is concluded that the pressure vessel allows treatment of advanced tumors in practically all sites without seriously limiting the application of x-ray fields which would be normally chosen with conventional megavoltage therapy. In the 110 cases local tumor disappearance was noted in 60% to 80%, depending on whether an optimistic or pessimistic view was taken of those cases with still uncertain status. (BBB)« less